Individual
AMANDA NICHOLLE SANDOVAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
9760 LA BRANCH DR, CORPUS CHRISTI, TX 78410-1538
(261) 903-6528
Mailing address
707 E RICHARD AVE, KINGSVILLE, TX 78363-4609
(361) 228-5312
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
116134
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116134
SPEECH LANGUAGE PATHOLOGIST TX
TX
Enumeration date
06/14/2022
Last updated
06/14/2022
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